| NPI | 1649384405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 22772) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: AZ 29447) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 105489) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-09-13 |