| NPI | 1356446595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 356083532) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 308919) |
| 208D00000X General Practice (Licence: OH 35.083532) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2023-05-10 |