| NPI | 1982609681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 04-30158) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: KS 04-30158) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2021-04-13 |