| NPI | 1578916516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: VA 0101034855) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101034855) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |