NPI | 1518320126 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 75640) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 66602) |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WI 75640) | |
Enumeration Date | 2016-03-31 |
Last Update Date | 2021-09-22 |