| NPI | 1982404448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: MA TBC-Pending) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA TBC-Pending) |
| 2084N0600X (Licence: MA TBC-Pending) | |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-03-14 |