| NPI | 1699975649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60583782) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P2374) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WA MD60583782) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2016-01-27 |