| NPI | 1033505490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: OK 34062) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2018-08-16 |