| NPI | 1982652657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WV 28628) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 17440) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 28628) | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: AL 17440) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-11-24 |