| NPI | 1326110842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 32012) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 17196) |
| 208000000X Pediatrics (Licence: SC 32012) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2009-08-13 |