| NPI | 1740415801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: TX N9967) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N9967) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2024-10-02 |