| NPI | 1336568484 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD60932490) | 
| Enumeration Date | 2014-04-15 | 
| Last Update Date | 2024-04-08 |