| NPI | 1306808654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: MN 43957) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 43957) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2018-01-03 |