| NPI | 1871752279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101248631) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC RESIDENT) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0101248631) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2022-01-13 |