| NPI | 1962497321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NC 2019-01232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2019-01232) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2024-07-15 |