| NPI | 1659446532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: NY 147904-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 147904-1) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 147904-1) | |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2007-07-08 |