| NPI | 1952550030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 135249) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NJ 25MA06835800) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: CA G44218) | |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |