| NPI | 1740381920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 43021) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2006-01503) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2010-08-04 |