| NPI | 1831452853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-00128) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: SC 34934) |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: NC 2022-00128) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2026-04-13 |