| NPI | 1851509137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0050074) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA R-7796) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CO 50074) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WY 10813A) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WY TL3608) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-04-13 |