| NPI | 1396921144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A114607) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CA A114607) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2025-09-10 |