| NPI | 1104386879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD489542) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2026-06-15 |