| NPI | 1093291817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2022042878) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2018018022) |
| Enumeration Date | 2018-07-15 |
| Last Update Date | 2023-09-06 |