| NPI | 1891893541 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA04107600) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA04107600) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NJ 25MA04107600) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-04-09 |