| NPI | 1124117098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 053555) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301083075) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 52791) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MI 4301083075) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-10-21 |