| NPI | 1487869624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX J5910) | 
| Enumeration Date | 2007-05-11 | 
| Last Update Date | 2007-07-08 |