| NPI | 1013110006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 29280) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 29280) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: AL 29280) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: AL 29280) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: AL 29280) | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: AL 29280) | |
| 273100000X Epilepsy Unit (Licence: AL 29280) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2023-03-07 |