| NPI | 1184682882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 49535) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 204580) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: NY 204580) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2018-09-19 |