| NPI | 1942654785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: TX T0866) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX T0866) | |
| 2084N0600X (Licence: TX T0866) | |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2024-09-16 |