| NPI | 1124097159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME75786) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL ME75786) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 044411) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2010-10-01 |