NPI | 1750342978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX L4349) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L4349) |
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MN 28123) | |
Enumeration Date | 2006-03-29 |
Last Update Date | 2020-03-04 |