| NPI | 1710402847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V8458) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: TX V8458) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX V8458) | |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2026-03-27 |