| NPI | 1053305508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine Sleep Medicine (Licence: MO R9773) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H5625) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2021-09-07 |