| NPI | 1568608404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101237042) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101237042) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 241966) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0101237042) | |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2021-07-23 |