| NPI | 1912979196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MD D77086) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 41489) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 41489) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2014-11-07 |