| NPI | 1275546558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301078125) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: MI 4301078125) |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MI 4301078125) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-09-24 |