| NPI | 1902878473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX L6703) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L6703) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR R-3612) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR R-3612) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: AR R-3612) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: TX L6703) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-02-03 |