| NPI | 1023322039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 49215) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101017299) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: CO 49215) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2015-10-14 |