| NPI | 1104031426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C159426) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2006-01121) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00048983) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: AL MD.31328) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-10-19 |