| NPI | 1154338986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00027455) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00027455) |
| 208000000X Pediatrics (Licence: WA MD00027455) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD00027455) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-10-14 |