| NPI | 1710022066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 300817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014044156) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 35824) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2014044156) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MO 2014044156) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD435971) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 300817) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2021-05-10 |