NPI | 1235158668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 73770) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 73770) |
208000000X Pediatrics (Licence: MA 73770) | |
Enumeration Date | 2006-07-18 |
Last Update Date | 2013-05-20 |