| NPI | 1003888637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME105958) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MN 48098) |
| 2084N0600X (Licence: FL ME105958) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2019-06-20 |