| NPI | 1154697589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA 1013558) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD458640) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 1013558) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2024-08-29 |