NPI | 1578023180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD70036148) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60949145) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2025-08-14 |