| NPI | 1629463062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 76788-20) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WI 76788-20) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2019011454) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-06-03 |