| NPI | 1558313015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WI 28456) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: WI 28456) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-03-04 |