| NPI | 1871725705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 53244) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 63601) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WI 63601) | |
| 208000000X Pediatrics (Licence: MN 53244) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2020-08-21 |