| NPI | 1588726749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX K 1085) | 
| Enumeration Date | 2006-12-14 | 
| Last Update Date | 2023-12-02 |