| NPI | 1215461702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KY IP1555) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2018-07-04 |