| NPI | 1891718243 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CA C170408)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35094003)  | 
| 208000000X Pediatrics (Licence: MI 4301078886)  | |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CA C170408)  | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MI 4301078886)  | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35094003)  | |
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2022-07-19 |