| NPI | 1245209766 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101048658) | 
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: VA 0101048658) | 
| 2084N0600X (Licence: VA 0101048658) | |
| Enumeration Date | 2006-03-16 | 
| Last Update Date | 2022-06-08 |