| NPI | 1245465541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: VA 0101273073) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: LA 206173) |
| Enumeration Date | 2009-05-16 |
| Last Update Date | 2021-10-19 |