| NPI | 1033321914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CO 48115) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NE 26744) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: UT 6312366-1205) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2021-07-01 |