| NPI | 1386098804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MI 4301503114) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301503114) |
| 207Q00000X Family Medicine (Licence: OH 35.136414) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2024-07-12 |