| NPI | 1164405460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL OS8644) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: FL OS8644) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 057817) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL OS8644) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2019-07-29 |