| NPI | 1427496850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME135705) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL35733) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2019-03-19 |