| NPI | 1659388585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MS 4986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 4986) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: MS 4986) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2023-01-04 |