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 |