| NPI | 1366884751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 279397) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 130556) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NY 279397) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2017-02-21 |