| NPI | 1730133547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 72622) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 23128) |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: SC 23128) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-03-19 |