| NPI | 1922122035 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME105000)  | 
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: FL ME105000)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-32200)  | |
| Enumeration Date | 2007-03-16 | 
| Last Update Date | 2016-11-10 |