| NPI | 1184291338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: NV DO4143) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5151015129) |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CA 20A24196) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-08-04 |