| NPI | 1861479628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: FL OS13733) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: CO 0055838) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.55838) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD H0061118) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2024-01-08 |