| NPI | 1174550388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME123731) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 041219) |
| 208000000X Pediatrics (Licence: FL ME123731) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2021-03-22 |