| NPI | 1972815983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME135044) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MI EMC0007196) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 337800) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2014039430) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2025-12-04 |