| NPI | 1649261884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX E2575) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: TX E2575) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2008-10-13 |