| NPI | 1083799001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX 2084N0402X) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-08-30 |