| NPI | 1265538458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 204673-1) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: NY 204673) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 204673) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-02-03 |