| NPI | 1891909586 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: VA 0101248318)  | 
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: MI 4301093961)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017485)  | |
| Enumeration Date | 2007-05-10 | 
| Last Update Date | 2010-09-29 |