| NPI | 1548312390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX K0079) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: TX K0079) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2025-04-14 |