| NPI | 1730174632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME119959) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: FL ME119959) |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: FL ME119959) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2017-04-18 |