| NPI | 1982911624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CA A136872) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301093987) |
| 208000000X Pediatrics (Licence: NY NA) | |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2018-09-15 |