| NPI | 1114451523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 19725) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2021-01192) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: SC 88714) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: ND PT19725) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2023-12-27 |