| NPI | 1881651131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 08417) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: MS 08417) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2019-07-10 |