| NPI | 1063989077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MI 4301503500) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 81101) |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2025-11-18 |