NPI | 1215249537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125058868) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 57435-20) |
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MI 4301105187) | |
Enumeration Date | 2010-07-02 |
Last Update Date | 2015-01-26 |