| NPI | 1942316542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD60396562) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 058195) |
| 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: WA MD60396562) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2013-09-10 |