| NPI | 1275553398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME49612) |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: FL HCO ID #488456) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2017-12-15 |