| NPI | 1588667372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: KS 04-24004) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 04-24004) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-12-06 |