| NPI | 1609081058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VT 042-0012198) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: VT 042-0012198) |
| 204R00000X Electrodiagnostic Medicine (Licence: VT 042-0012198) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2014-07-02 |