| NPI | 1912455106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX F2553) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |