| NPI | 1740888296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 28) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: CA 0028) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-12-24 |