| NPI | 1477558674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 9739) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 38555) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NV 9739) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2021-08-04 |