| NPI | 1134267719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D 0023633) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MD D 0023633) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: MD D 0023633) | |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2007-07-08 |