| NPI | 1598253957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TN 65073) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: SC 85778) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: SC 85778) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2024-01-16 |