| NPI | 1033347521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX Q1313) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT195437) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2026-01-03 |