| NPI | 1760479091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 43770) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 43770) |
| 208000000X Pediatrics (Licence: NH 6074) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NH 6074) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2007-10-10 |