| NPI | 1417246760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD460835) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD460835) |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: PA MD460835) | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2024-03-18 |