| NPI | 1396737714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 30811) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 30811) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 30811) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2014-11-04 |