| NPI | 1861945818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: TX T5036) |
| Additional Taxonomies | 2084N0008X Psychiatry & Neurology Neuromuscular Medicine (Licence: TX T5036) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: MN 67346) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 69526) | |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2024-01-12 |