NPI | 1578518155 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: UT 4979065-1205) |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 4979065-1205) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 4979065-1205) | |
Enumeration Date | 2006-05-23 |
Last Update Date | 2021-10-28 |