| NPI | 1831388990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036108421) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301075030) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NY 254015) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WI 56307) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2022-11-10 |