| NPI | 1174645444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA02833700) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |