| NPI | 1225245509 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: NJ 25MA08253900)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0007789)  | 
| Enumeration Date | 2007-05-17 | 
| Last Update Date | 2024-10-07 |