| NPI | 1114217593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX R5869) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2018-07-10 |