| 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 |