| NPI | 1730063264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: AL F10241080) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 1891829073) |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-05 |