| NPI | 1063625234 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.099449)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.099449)  | 
| 2084N0600X  (Licence: OH 35.099449)  | |
| Enumeration Date | 2007-05-07 | 
| Last Update Date | 2022-11-30 |