| NPI | 1619970738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME79332) |
| Additional Taxonomies | 207YS0012X (Licence: FL 79332) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-06-26 |