| NPI | 1609125905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME131903) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2022-08-04 |