| NPI | 1699185256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: OR DO181937) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60476473) |
| 207Q00000X Family Medicine (Licence: WA OP60576320) | |
| 207Q00000X Family Medicine (Licence: OR DO181937) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2023-05-17 |