NPI | 1124173026 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301093239) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD427264) |
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MI 4301093239) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2019-06-26 |