| NPI | 1629414834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: AZ 60469) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ R74659) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2026-04-21 |