| NPI | 1114292588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101274037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0092220) |
| 207Q00000X Family Medicine (Licence: DC MD049407) | |
| 207QS1201X Family Medicine Sleep Medicine (Licence: DC MD049407) | |
| Enumeration Date | 2012-03-17 |
| Last Update Date | 2023-10-06 |