| NPI | 1578588083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: SC 37778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9700696) |
| 208000000X Pediatrics (Licence: NC 9700696) | |
| 208000000X Pediatrics (Licence: SC 37778) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 9700696) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-04-12 |