| NPI | 1265786990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: PA MD469969) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: NY 293427) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2021-02-22 |