| NPI | 1598079568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 76785-20) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NE 27914) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301102715) | |
| 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: WI 76785-20) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 120984) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2022-06-21 |