| NPI | 1164050084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 13867728-1205) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: UT 13867728-1205) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL L.5275) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-04-15 |