| NPI | 1801030473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA09419300) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 262027) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA09419300) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2020-12-04 |