| NPI | 1497989800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME129764) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: PA MT192814) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35123456) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35123456) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2016-12-16 |