| NPI | 1619082070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: UT 42139546-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML20008670) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2025-11-11 |