| NPI | 1366679615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: CA A126021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10035328) |
| 207Q00000X Family Medicine (Licence: TX P3392) | |
| Enumeration Date | 2009-06-14 |
| Last Update Date | 2024-01-18 |