NPI | 1831759596 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61357479) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN29309) |
207QS1201X Family Medicine, Sleep Medicine (Licence: WA MD61357479) | |
207RS0012X Internal Medicine, Sleep Medicine (Licence: FL ME154593) | |
Enumeration Date | 2019-06-15 |
Last Update Date | 2023-07-14 |