| NPI | 1316232705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 265554) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 55251) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 55251) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2018-04-24 |