NPI | 1710419783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MI 5101023082) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101023082) |
Enumeration Date | 2017-03-29 |
Last Update Date | 2025-04-22 |