| NPI | 1760809743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: MA 274613) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA 274613) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 23112) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 274613) | |
| 2084N0600X (Licence: NH 23112) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2025-08-13 |