| NPI | 1265512669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35-091986) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX M3010) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2012-10-01 |