| NPI | 1881037059 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: VA 010125755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 116277) |
| 207R00000X Internal Medicine (Licence: HI MD-20750) | |
| 207R00000X Internal Medicine (Licence: VA 0101257355) | |
| 208D00000X General Practice (Licence: VA 0101257355) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2024-07-17 |