| NPI | 1740415686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A144380) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME113707) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 250505) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: FL ME113707) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2019-09-04 |