| NPI | 1528012051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 37127) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 32599) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 48814) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 37127) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2022-05-18 |