| NPI | 1841619053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME146975) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-09-13 |