| NPI | 1750477071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 118533) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 118533) |
| 208000000X Pediatrics (Licence: NJ 25MA03182300) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA03182300) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-03-20 |