| NPI | 1295896223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY NYLic#193810) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY NYLic#193810) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |