| NPI | 1154306207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 31821) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: KY 31821) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2024-01-08 |