| NPI | 1588808034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME132445) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101263537) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 50903) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA MD-42422) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-138634) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: KY 47414) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35.124440) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: GA 69752) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2022-12-23 |