| NPI | 1679518880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: WA MD00038659) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00038659) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2022-10-12 |