| NPI | 1689136368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 1013155) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA 1013155) |
| 311500000X Alzheimer Center (Dementia Center) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-07-20 |