| NPI | 1720252216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: ND 12911) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2018-07-18 |