| NPI | 1639312101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: SC 36514) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: GA 69376) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 36514) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2023-05-11 |