| NPI | 1376675678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MO 2007010563) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: KS 0432345) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2007010563) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2025-01-14 |