| NPI | 1376005553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: UT 14202962-1204) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2025-11-11 |