| NPI | 1821232034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 051199) |
| Additional Taxonomies | 207QS1201X Family Medicine Sleep Medicine (Licence: CT 051199) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2022-01-25 |