| NPI | 1508503483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: UT 14211172-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 211-T1) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2025-03-24 |