| NPI | 1134319619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MS 20177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 20177) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2014-02-04 |