| NPI | 1083879522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: CT 49253) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: CT 49253) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: OH 35.092352) | |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2017-10-06 |