| NPI | 1063623973 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MD D84053) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA mt186349) | 
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD436699) | |
| Enumeration Date | 2007-05-24 | 
| Last Update Date | 2024-09-26 |