| NPI | 1700266988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MA 1025754) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: MA 1025754) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: VA 0101262244) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2026-04-22 |