| NPI | 1154419851 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25ma07633900) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA md072786l) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NJ 25MA07633900) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: PA MD072786L) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-05-08 |