| NPI | 1447381728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M7461) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 66290) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2019-0906) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 66290) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2024-02-21 |