| NPI | 1225036031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MI 4301039896) | 
| Enumeration Date | 2005-07-14 | 
| Last Update Date | 2011-10-20 |