| NPI | 1548362114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 54332) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 34241) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 54332) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-07-09 |