| NPI | 1003841271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 2012-01818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-084766) |
| 208000000X Pediatrics (Licence: MO 2007035010) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35-084766) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MO 2007035010) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2017-02-16 |