NPI | 1578697348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 40701) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 40701) |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KY 40701) | |
Enumeration Date | 2007-03-15 |
Last Update Date | 2019-03-12 |