| NPI | 1063412492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA03599100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 192236-1) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA03599100) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NY 192236-1) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2008-04-18 |