| NPI | 1215270533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: CA A174833) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: CA A174833) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A174833) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 56992) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA A174833) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2023-11-09 |