| NPI | 1912008079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: ID M-6614) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M6614) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-03-29 |