| NPI | 1578527701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 33487) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 060111) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CT 060111) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: AZ 33487) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-05-05 |