NPI | 1396237582 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MD D0094823) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116031484) |
207Q00000X Family Medicine (Licence: MD D0094823) | |
Enumeration Date | 2018-06-04 |
Last Update Date | 2025-01-22 |