| NPI | 1578765855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: GA 95572) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: VT 0016970) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: NY 323034) | |
| 207Q00000X Family Medicine (Licence: NE 24609) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-08-09 |