| NPI | 1669651667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: NC 129145) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: NC 129145) |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: OK 27941) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2020-12-14 |