| NPI | 1508885955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: LA 05634R) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: LA 05634R) |
| 2084N0600X (Licence: LA 05634R) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-06-20 |