| NPI | 1245431105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0012X Pediatrics, Sleep Medicine (Licence: KY 60172) |
| Additional Taxonomies | 2080S0012X Pediatrics, Sleep Medicine (Licence: SC 35354) |
| 2080S0012X Pediatrics, Sleep Medicine (Licence: MT MED-PHYS-LIC-70337) | |
| 207R00000X Internal Medicine (Licence: SC 35354) | |
| 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-70337) | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: MT MED-PHYS-LIC-70337) | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: KY 60172) | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: SC 35354) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2025-03-21 |