| NPI | 1518129162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: CA A110337) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A110337) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2014-03-28 |