| NPI | 1417339409 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: TX S9499)  | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX S9499)  | 
| Enumeration Date | 2015-06-25 | 
| Last Update Date | 2024-09-30 |