| NPI | 1871784892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: VA 0101246345) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2003-00551) |
| 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: NC 2003-00551) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116015767) | |
| 207T00000X Neurological Surgery (Licence: VA 0101246345) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2018-02-15 |