| NPI | 1104110212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 316629) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: NY 316629) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A131016) | |
| 207R00000X Internal Medicine (Licence: AZ R72835) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-07-13 |