| NPI | 1639381619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CA A128441) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NV 14343) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2014-07-03 |