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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 only

Email (required)
Visibility:anyoneIICN Members and Admin only

Institution 1

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

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