| NPI | 1417110651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine (Licence: NY 257436) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 257436) |
| 207RS0012X Internal Medicine Sleep Medicine (Licence: NY 257436) | |
| 208000000X Pediatrics (Licence: NY 257436) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2018-02-12 |