| NPI | 1265609234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: IA 38345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 38345) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 57-011386) | |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2012-01-23 |