| NPI | 1023081775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: FL ME102097) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 39298) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME102097) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2011-10-07 |