| NPI | 1255072674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MN 74631) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 74631) |
| 208000000X Pediatrics (Licence: MN 32605) | |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2024-06-19 |