| NPI | 1750605200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: MD D007751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD039449) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2014-07-01 |