| NPI | 1295728897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: AZ 009868) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID O-333) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2022-11-07 |