| NPI | 1124558911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: CO DR.0077827) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT213803) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2026-06-05 |