| NPI | 1417184714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX P7511) |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology Brain Injury Medicine (Licence: TX P7511) |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: TX P7511) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2019-05-07 |