| NPI | 1790926434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04597) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: MD 04597) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2019-10-30 |