| NPI | 1639520547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NE 33333) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 267859) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2021-09-24 |