| NPI | 1770925976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: GA 82879) |
| Additional Taxonomies | 2084N0600X (Licence: GA 82879) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 82879) | |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MI 4301510570) | |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2026-07-17 |