NPI | 1538513031 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: AZ 74819) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10055833) |
Enumeration Date | 2016-04-20 |
Last Update Date | 2024-12-19 |