| NPI | 1609857010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 67336) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 209238) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 67336) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CT 040449) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NY 209238) | |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2022-03-09 |