| NPI | 1730130576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA C54540) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C54540) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI Neurology) | |
| 204R00000X Electrodiagnostic Medicine (Licence: CA C54540) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2023-11-10 |