| NPI | 1164590501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CA A72698) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A72698) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: VA 0101248173) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: DC MD038986) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2014-03-04 |