| NPI | 1770776361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 290487) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD448813) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: PA MD448813) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2021-12-03 |