| NPI | 1124148341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MD D67411) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 224324) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-10-07 |