| NPI | 1164780748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 58709) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL L7880) |
| 2084N0600X (Licence: FL ME142433) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME142433) | |
| 2084E0001X Psychiatry & Neurology, Epilepsy (Licence: FL ME142433) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 67673) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 60522) | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2023-06-30 |