| NPI | 1629360144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 2010-01822) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MN 58305) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD60915844) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 58305) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2021-04-27 |