| NPI | 1952863722 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine (Licence: AZ 011181)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 331357)  | 
| Enumeration Date | 2019-04-02 | 
| Last Update Date | 2025-07-15 |