| NPI | 1811978539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 017066) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: CT 17066) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2007-07-08 |