| NPI | 1124116942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ MA069939) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ MA69939) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NY 230269) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-10-16 |