| NPI | 1093009680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 274222) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 274222) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 274222) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2016-11-09 |