| NPI | 1922090851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 37540) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 40433) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: IA 34030) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2020-08-20 |