| NPI | 1336288364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 60055) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL ME109883) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM 2004-0408) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 50641) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-01-31 |