| NPI | 1124173026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MI 4301093239) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301093239) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD427264) | |
| 2084N0600X (Licence: MI 4301093239) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-12-30 |