| NPI | 1932109378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: OH 35.080807) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 215175) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA07286300) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: MS 21821) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2022-01-13 |