| NPI | 1164721742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U3987) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME122308) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 52121) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: AZ 52121) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2023-09-21 |