| NPI | 1235303678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 55624) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57-014149) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 106093) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 257709) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-11-13 |