| NPI | 1467405522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301503579) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35083816) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35083816) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-09-11 |