| NPI | 1699934604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301092655) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: MI 4301092655) |
| 207T00000X Neurological Surgery (Licence: MI 4301092655) | |
| 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: MI 4301092655) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2023-11-30 |