| NPI | 1609825181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 156818) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: FL ME120314) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-12-03 |