| NPI | 1669570255 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M0648) | 
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: TX M0648) | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2024-01-30 |