| NPI | 1487886172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: NJ 49FW00042100) |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: NJ 49FW00042100) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2026-05-04 |