| NPI | 1407206626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 34.016096) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.069499) |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2023-09-27 |