| NPI | 1205327392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: FL ME156292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11139) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2022-06-20 |