| NPI | 1932229879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 2011-00198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 001908) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: NC 2011-00198) | |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2023-03-07 |