| NPI | 1780627018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 5101008581) |
| Additional Taxonomies | 2084N0600X (Licence: MI 5101008581) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: MI 5101008581) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-01-18 |