| NPI | 1003996844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CA A43543) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A43543) |
| 261QH0100X Clinic/Center, Health Services (Licence: CA A43543) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2024-04-02 |