| NPI | 1427357219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: SC 40817) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35120510) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2021-06-29 |