| NPI | 1760442750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX M3414) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME82475) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: TX M3414) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2012-02-13 |