NPI | 1578777546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
Enumeration Date | 2007-05-09 |
Last Update Date | 2007-07-08 |