| NPI | 1659757359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA MD61315332) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61315332) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WA MD61315332) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2022-11-16 |