| NPI | 1295053593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME117746) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: FL ME117746) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL ME117746) | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: FL ME117746) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2019-12-13 |