| NPI | 1912062035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA 60508358) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.093501) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2006038718) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A83409) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WA 60508358) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA A83409) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2021-06-15 |