| NPI | 1669489597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 13013) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 60275) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD21837) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OR MD21837) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2022-04-29 |