| NPI | 1841713088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 76769-20) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: WI 76769-20) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-09-28 |