| NPI | 1518962851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 04-24326) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: KS 04-24326) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2007018724) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: MO 2007018724) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2014-02-27 |