| NPI | 1740675669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: WA ML61042579) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 60562496) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-04-19 |