| NPI | 1710959762 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M5436)  | 
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: TX M5436)  | 
| Enumeration Date | 2006-02-03 | 
| Last Update Date | 2025-06-02 |