| NPI | 1003997362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD00034001) |
| Additional Taxonomies | 2084N0600X (Licence: WA MD00034001) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-09-13 |