| NPI | 1295785087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: 4188) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-09-13 |