| NPI | 1356449177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MA05766300) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: NJ 25MA05766300) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-04-22 |