| NPI | 1114934080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0012X Pediatrics, Sleep Medicine (Licence: VT 042-0010926) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: NY 281927) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2022-01-20 |