| NPI | 1295364123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: WA MD61520500) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61520500) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-07-28 |