| NPI | 1740467422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 76049) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD425101) |
| 208000000X Pediatrics (Licence: MO 2013022987) | |
| 208000000X Pediatrics (Licence: KS 0436550) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD425101) | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: MO 2013022987) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MO 2013022987) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KS 0436550) | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: PA MD425101) | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: KS 0436550) | |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2024-03-28 |