| NPI | 1568581551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MT 33975) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 6679271-1205) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: UT 6679271-1205) | |
| 2084N0600X (Licence: UT 6679271-1205) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2021-12-13 |