| NPI | 1255419941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: CA A78961) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A78961) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A78961) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-12-05 |