| NPI | 1700225042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: NC 2016-00390) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A161202) |
| 207Q00000X Family Medicine (Licence: NC 2016-00390) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2024-09-19 |