| NPI | 1538124391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 194359) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 194359) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 194359) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2014-09-20 |