| NPI | 1649563917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO 31479) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: CO 31479) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |