| NPI | 1265469878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G52739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G52739) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA G52739) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2017-10-13 |