| NPI | 1083970032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 2019-00791) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2019-00791) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-08-29 |