| NPI | 1720161011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 109177) | 
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: NC 200200197) | 
| Enumeration Date | 2006-10-23 | 
| Last Update Date | 2022-02-10 |