| NPI | 1609403765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 76977) |
| Additional Taxonomies | 2084N0600X (Licence: TN 76676) |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: TN 76676) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-05-09 |