| NPI | 1962524884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME102384) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: FL ME102384) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA08212900) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2010-06-26 |