| NPI | 1730163114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OS9320) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: FL OS9320) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2012-04-18 |