NPI | 1407961758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: NY 238538) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 238538) |
207RS0012X Internal Medicine, Sleep Medicine (Licence: NY 238538) | |
Enumeration Date | 2006-08-19 |
Last Update Date | 2025-01-02 |