| NPI | 1881757656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 20309) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 20309) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-11-06 |