| NPI | 1831108455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA OP00001949) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SD 7330) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IA DO-04320) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IN 02003790A) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: ID O-1291) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-06-27 |