| NPI | 1356904726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 338664-01) |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2026-01-12 |