| NPI | 1083700041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N4890) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N4890) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: TX N4890) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-03-27 |