| NPI | 1558943548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: NC 2026-00685) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2024-00685) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2026-09-04 |