| NPI | 1740455161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301100140) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: MI 4301100140) |
| 204R00000X Electrodiagnostic Medicine (Licence: MI 4301100140) | |
| 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: MI 4301100140) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35.097562) | |
| Enumeration Date | 2008-04-26 |
| Last Update Date | 2019-11-11 |