| NPI | 1497113195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: VA 0102207250) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT016908) |
| 208000000X Pediatrics (Licence: PA OS019607) | |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-08-05 |