| NPI | 1205383023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282NC2000X General Acute Care Hospital, Children (Licence: AL 35404) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: AL 35404) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2024-02-01 |