| NPI | 1508360678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX U4355) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101268438) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: VA 0101268438) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-09-17 |