NPI | 1164491122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: AZ 61241) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM MD2008-0782) |
207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NM MD2008-0782) | |
207Q00000X Family Medicine (Licence: NM MD2008-0782) | |
207QS1201X Family Medicine, Sleep Medicine (Licence: NM MD2008-0782) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2024-01-08 |