| NPI | 1750902193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 2025-01784) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2026-02-09 |