NPI | 1104212463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: NY 296052) |
Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: PA MD467980) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2023-08-03 |