| NPI | 1265092670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2024007984) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2019019502) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-07-15 |