| NPI | 1942229166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 40199) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: KY 40199) |
| 174400000X Specialist (Licence: KY 40199) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-11-09 |