| NPI | 1780809541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: CT 57152) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 47266) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 57152) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: KY 47266) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CT 57152) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2023-02-20 |