| NPI | 1124011366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY A1693881) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 029705) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NY 169388) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2010-02-05 |