| NPI | 1003182007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-00562) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC MD20000022) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A130816) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D85494) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101264710) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0101264710) | |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2025-01-17 |