| NPI | 1831411693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX T0839) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T0839) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.094532) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX 46541) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35.094532) | |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2021-04-27 |