| NPI | 1154347862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME159713) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 229746) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A91801) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA A91801) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-12-16 |