| NPI | 1538773189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2020014567) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025017334) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2025-09-07 |