| NPI | 1790211878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME169075) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101265274) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-10-21 |