| NPI | 1689916637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: PA OS018753) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS018753) |
| 208D00000X General Practice (Licence: NE 1218) | |
| Enumeration Date | 2013-03-17 |
| Last Update Date | 2024-09-11 |