| NPI | 1336329192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MA 260932) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: NY 280030) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2019-05-20 |