| NPI | 1063631281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N8602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 222413) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA A102066) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX N8602) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2014-11-21 |