| NPI | 1144321373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 24599) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 24599) |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: NC 24599) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |