NPI | 1114205838 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: OH 35.C000357) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-44640) |
2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: IA MD-44640) | |
Enumeration Date | 2011-07-29 |
Last Update Date | 2023-03-24 |