NPI | 1952974784 |
---|---|
Former Name | E E E |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: ID 7071562) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT223162) |
Enumeration Date | 2021-07-20 |
Last Update Date | 2025-07-01 |