| NPI | 1922153667 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MD D0073184)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 206550)  | 
| Enumeration Date | 2007-01-24 | 
| Last Update Date | 2024-10-10 |