| NPI | 1689011207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: PA MD463980) |
| Additional Taxonomies | 2084N0600X (Licence: PA 463980) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2025-05-07 |