| NPI | 1225193105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 200601910) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: NC 2006-01910) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2015-08-05 |