| NPI | 1841286994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 055487) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OH 35076214) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: AR E-6501) | |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CT 055487) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2022-09-29 |