| NPI | 1710989900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 3158) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: OK 3158) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-05-26 |