| NPI | 1114192093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.122225) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122225) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2015-02-04 |