| NPI | 1649236647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine Sleep Medicine (Licence: MO 20030000620) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: MO 2003000620) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: KS 0425916) | |
| 207RS0012X Internal Medicine Sleep Medicine (Licence: KS 0425916) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2014-01-27 |