| NPI | 1689137234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: KY 56318) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2024-08-30 |