| NPI | 1801328521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 64197) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 28436) |
| 208000000X Pediatrics (Licence: MN 64197) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-01-23 |