| NPI | 1700306867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021028092) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MO 2021028092) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2026-04-02 |