| NPI | 1376076356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U2650) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: TX U2650) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX U2650) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U2650) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2026-03-27 |