| NPI | 1124024849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: GA 63922) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 38252) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2010-04-22 |