| NPI | 1124305297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.122215) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122215) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2017-02-06 |