| NPI | 1942429485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME110491) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35130717) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 85431) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: FL ME110491) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2025-10-29 |