| NPI | 1194712208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D83244) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NH 10401) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 79897) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MA 79897) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NH 10401) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2021-04-14 |