| NPI | 1285832741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PR 17645) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 17645) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: PR 17645) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2015-03-20 |