| NPI | 1598840209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A40934) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CA A40934) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2010-10-20 |