| NPI | 1255776589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME160843) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2023-03-09 |