| NPI | 1306131453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: UT 9349026-1205) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2011015246) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2021-11-08 |