| NPI | 1700047594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 248987) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NY 243554) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA08772500) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA08772500) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2011-02-14 |