| NPI | 1831570019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: KY 58575) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: KY 58575) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: IN 01082703A) | |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2023-11-10 |