| NPI | 1558388389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NJ 25MB08082800) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: NJ 25MB08082800) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-11-03 |