| NPI | 1407167372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2013005666) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0438024) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MO 2013005666) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KS 04-38024) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2023-07-24 |