| NPI | 1023102498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: CO 0052058) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 2001156) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: NM 2001-156) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-06-12 |