| NPI | 1841395902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 39574) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 38855) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: KY 38855) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2015-07-13 |