| NPI | 1124102843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD00019344) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-03-01 |