| NPI | 1922411453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: CA C167607) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: PA MT207209) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: FL ME160356) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2025-07-17 |