| NPI | 1528051653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: IA MD-29194) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA 29194) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: IA MD-29194) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2023-12-15 |