| NPI | 1831260470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 00G209611) |
| Additional Taxonomies | 207RS0012X Internal Medicine Sleep Medicine (Licence: CA 00G209611) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2018-05-07 |