| NPI | 1790018000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NC 2016-01267) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD447132) |
| 208000000X Pediatrics (Licence: KY 46343) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KY 46343) | |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2017-01-10 |