| NPI | 1154461531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35098202) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME166109) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301112703) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ME 018601) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MI 4301112703) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2024-02-27 |