| NPI | 1386317931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: NV 27472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 27472) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-07-23 |