| NPI | 1053930198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MI 5101029188) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-03-17 |