NPI | 1578983581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301115211) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 71724) |
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MI 4301115211) | |
2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: MI 4301115211) | |
2084S0010X Psychiatry & Neurology, Sports Medicine (Licence: MI 4301115211) | |
Enumeration Date | 2014-04-17 |
Last Update Date | 2022-07-22 |