| NPI | 1205104411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME177505) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX W1051) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0067293) | |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CO DR.0067293) | |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2025-10-24 |