| NPI | 1659470201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS 5502) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: FL OS5502) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-12-16 |