| NPI | 1992726350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: NJ 25MA08211900) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2012-02-10 |