NPI | 1871886721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: TX R8174) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301099113) |
207QS1201X Family Medicine, Sleep Medicine (Licence: CA C162368) | |
207R00000X Internal Medicine (Licence: WA MD60693801) | |
Enumeration Date | 2011-05-25 |
Last Update Date | 2024-05-03 |