| NPI | 1275591976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35.083358) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD426120) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: PA MD426120) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: OH 35.083358) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-07-21 |