| NPI | 1780651893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G85628) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: CA G85628) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2007-07-08 |