| NPI | 1295099836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: ND 15124) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q1518) |
| 207Q00000X Family Medicine (Licence: ND 15124) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2024-07-05 |