| NPI | 1104025634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: OR MD154185) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 81871) |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2021-09-01 |