NPI | 1861924284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: LA 335689) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TN 66219) | |
Enumeration Date | 2017-04-03 |
Last Update Date | 2023-03-28 |