| NPI | 1568999472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX 45692) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-07-21 |