| NPI | 1568083616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME167893) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2025-07-01 |