| NPI | 1750743571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 62961) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: CO 62961) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME162552) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U6209) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2024-04-05 |