| 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 | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: FL ME177211) |
| 208000000X Pediatrics (Licence: WA ML60949145) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-11-18 |