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Title (Prof., Dr., Ms., Mrs., Mr.) (required) First name (required) Middle name Last name (required) Retired
Specialties (required) Adult NeurologyClinical NeurophysiologyNeuroanaesthesiologyNeuroanatomyNeuroepidemiologyNeurogeneticsNeuro-ophthalmologyNeuropathologyNeuropharmacologyNeuropsychiatryNeuropsychologyNeuroradiologyNeurorehabilitationNeurosurgeryPaediatric NeurologyPsychiatryPsychologyOtherNull Current position Contact address Telephone Visibility:anyoneIICN Members and Admin onlyIICN Admin only
Email (required) Visibility: anyoneIICN Members and Admin onlyIICN Admin only
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Name of institution (required) Department (required)
Institution 2
Name Department
Secretary name Secretary telephone Secretary email
Areas of clinical and academic interest Existing collaborations Additional information Photo or image of you (optional)