| NPI | 1578508693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA08501000) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: NJ 25MA08501000) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA08501000) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2012-05-14 |