| NPI | 1316367626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: WV 28029) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: LA 308924) |
| 207Q00000X Family Medicine (Licence: WV 28029) | |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2020-08-21 |