| NPI | 1972958593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD209787) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD61045478) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 12236677-1205) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: UT 12236677-1205) | |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2024-05-22 |