| NPI | 1124051321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 11945) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX G8472) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MS 11945) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX G8472) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2014-04-07 |