| NPI | 1073547741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TN 60776) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD068237L) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME112284) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD068237L) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD068237L) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-05-26 |