| NPI | 1902803380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NY 294723) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA08853600) |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: PA MD453730) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NJ 25MA08853600) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2018-10-03 |