| NPI | 1770032427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: ZZ CREMESP 117664) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ CPSO# 101447) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |