| NPI | 1902063662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: VA 0101274057) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101274057) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101274057) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-11-01 |