| NPI | 1437503935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080S0012X Pediatrics, Sleep Medicine (Licence: MN 65325) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 65325) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2020-08-04 |