| NPI | 1902474604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: MN 79126) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2021022433) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2026-06-20 |