| NPI | 1679912778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: IA MD-48125) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116026310) |
| 207Q00000X Family Medicine (Licence: IA MD-48125) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2021-07-08 |