| NPI | 1245659242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: OH 35.132125) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: NY 313653) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2025-04-11 |