| NPI | 1558463232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD043422-E) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: PA MD043442E) |
| 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: PA MD043442E) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2021-01-24 |