| NPI | 1609115872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX R4212) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TN 54042) |
| 282NW0100X General Acute Care Hospital, Women | |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2020-12-22 |