| NPI | 1336565225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: PA OS022982) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203639) |
| Enumeration Date | 2014-03-15 |
| Last Update Date | 2023-10-30 |