| NPI | 1275571481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KY 19719) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 19719) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: KY 19719) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 19719) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2019-02-15 |