| NPI | 1548206618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2019017086) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME114072) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA BC60686820) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME114072) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2019-09-12 |