NPI | 1801328521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 64197) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 28436) |
208000000X Pediatrics (Licence: MN 64197) | |
208000000X Pediatrics (Licence: MD D0101215) | |
Enumeration Date | 2017-03-31 |
Last Update Date | 2024-10-14 |