| NPI | 1982635769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35-080932) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 35.080932) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-04-16 |