| NPI | 1265488340 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 47188) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 47188) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-05-18 |