| NPI | 1639759020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A192164) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: CA A192164) |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2026-01-20 |