| NPI | 1578518155 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: UT 4979065-1205) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 4979065-1205) | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 4979065-1205) | |
| Enumeration Date | 2006-05-23 | 
| Last Update Date | 2021-10-28 |