| NPI | 1861585408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WI 27172) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 27172) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WI 27172) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-10-17 |