| NPI | 1891283867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D97872) |
| Additional Taxonomies | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA 1020811) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 1020811) | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2025-03-04 |