| NPI | 1982676714 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MN 38980) | 
| Enumeration Date | 2006-02-06 | 
| Last Update Date | 2007-07-08 |