| NPI | 1215291653 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MO 2017019125)  | 
| Enumeration Date | 2012-06-29 | 
| Last Update Date | 2024-04-25 |