| NPI | 1790764058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M3856) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: TX M3856) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2024-07-25 |