| NPI | 1568501559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60823477) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM 2006-0403) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-34526) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KS 04-34526) | |
| 2084N0600X (Licence: KS 04-34526) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-08-03 |