NPI | 1487001061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: NV 20879) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A168176) |
207Q00000X Family Medicine (Licence: NV 20879) | |
Enumeration Date | 2016-05-24 |
Last Update Date | 2021-04-19 |