| NPI | 1013968858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 01389) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 31216) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME127847) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME127847) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-10-06 |