| NPI | 1699794958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: MI 4301069390) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301069390) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-12-14 |