| NPI | 1477710036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: WI 52175) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 52175-20) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2026-04-10 |