| NPI | 1851770200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: MA 1017333) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 1017333) |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MA 1017333) | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: NY 326772) | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: NY 326772) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 1017333) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2024-05-23 |