| NPI | 1689668832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: FL ME169881) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 234744) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101243229) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2024-10-24 |