| NPI | 1821035254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0008X Psychiatry & Neurology, Neuromuscular Medicine (Licence: AZ 25540) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 25540) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 25540) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: AZ 25540) | |
| 261QI0500X Clinic/Center, Infusion Therapy (Licence: AZ 25540) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2019-08-08 |