NPI | 1578849444 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: GA 069749) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 005364) |
207QS1201X Family Medicine, Sleep Medicine (Licence: NC 2015-00835) | |
207QS1201X Family Medicine, Sleep Medicine (Licence: GA 69749) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2015-00835) | |
207Q00000X Family Medicine (Licence: GA 069749) | |
Enumeration Date | 2011-10-24 |
Last Update Date | 2016-11-08 |