| NPI | 1316993975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 29166) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 29166) |
| 174400000X Specialist (Licence: NC 29166) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2017-10-23 |