| NPI | 1821012204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: PA MD073718L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD073718L) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: PA MD073718L) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-03-05 |