| NPI | 1760575765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810002163) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 03368) |
| 173F00000X Sleep Specialist, PhD (Licence: VA 0810002163) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-12-11 |