| NPI | 1699136598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 283087) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA 283087) |
| Enumeration Date | 2016-03-19 |
| Last Update Date | 2024-01-17 |