NPI | 1457748394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.138612) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.138612) |
Enumeration Date | 2015-04-17 |
Last Update Date | 2020-07-06 |