| NPI | 1669764924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD176896) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60688707) |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CA C183246) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID MC-1643) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C183246) | |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2026-07-02 |