| NPI | 1700306867 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MO 2021028092) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021028092) | 
| Enumeration Date | 2017-06-21 | 
| Last Update Date | 2025-04-17 |