| NPI | 1275741647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301081479) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: MI 4301081479) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-10-11 |