| NPI | 1659343564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 9331048-1205) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: UT 9331048-1205) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 23114) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: UT 9331048-1205) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2018-11-12 |