| NPI | 1225245509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: NY 250887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0007789) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-06-26 |