| NPI | 1295239150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD61467799) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61467799) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: WA MD61467799) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD61467799) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-09-06 |