| NPI | 1619974474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35051881S) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35051881) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2011-05-25 |