| NPI | 1821431123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MO 2018014545) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX R1743) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2018014545) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX R1743) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2018-07-02 |