| NPI | 1578613022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME 114935) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PR 13655) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2023-10-26 |