| NPI | 1760612659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: NV 17053) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: NM MD2019-0793) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: NV 17053) | |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2020-09-01 |