| NPI | 1538476189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL TRN14768) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: ND PT22143) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2025-02-20 |