| NPI | 1932669884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MN 67757) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 67757) |
| 208000000X Pediatrics (Licence: MN 30042) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2021-06-22 |