| NPI | 1306285432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: AZ 57453) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2022-03-05 |