| NPI | 1134412901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MN 57381) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 57381) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MN 57381) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2024-03-05 |