| NPI | 1710374111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2019016454) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR 177117) |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: MO 2019016454) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2023-04-04 |