| NPI | 1851367122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 14107) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PR 14107) |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: PR 14107) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: PR 14107) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2013-11-05 |