NPI | 1285195735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: WA MD61665639) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61665639) |
Enumeration Date | 2019-03-27 |
Last Update Date | 2025-09-04 |