| NPI | 1073503660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME 12092) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: ME MD12092) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2013-03-20 |