| NPI | 1114218120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: OR MD195923) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD60621883) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2020-10-07 |