NPI | 1568666352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: VA 0101254897) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.097805) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2012-01033) | |
2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NC 2012-01033) | |
2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: OH 35.097805) | |
Enumeration Date | 2007-06-13 |
Last Update Date | 2019-03-25 |