| NPI | 1477741189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD439273) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A105212) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD439273) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2023-05-30 |