| NPI | 1063421964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME108455) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 11084) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NH 11084) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NH 11084) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2012-06-26 |