| NPI | 1750313110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 01621) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME176911) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2002-01621) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX W2772) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2026-01-06 |