| NPI | 1780600700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 70946) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MA 70946) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 70946) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2014-10-13 |