| NPI | 1629211891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GU M-1847) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR 161576) | 
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: OR 161576) | |
| Enumeration Date | 2009-04-17 | 
| Last Update Date | 2015-02-16 |