| NPI | 1851308308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD020130E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD020130E) |
| 208000000X Pediatrics (Licence: NJ 25MA03511800) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA03511800) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-03-20 |