| NPI | 1407142474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2011022935) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA08817500) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2012-03-20 |