| NPI | 1649256223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-00762) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0101251506) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME141226) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0068903) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60122810) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101251506) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2024-10-25 |