| NPI | 1689620387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NY 232830) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: NY 232830) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-06-11 |