| NPI | 1710058730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: PA MD036291L) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NM 95-118) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: KY 49598) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: KY TP318) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2016-09-20 |