| NPI | 1699069559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 257666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 247597) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MA 247597) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-02-04 |