| NPI | 1962447730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD20167) |
| Additional Taxonomies | 2084N0600X (Licence: OR MD20167) |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: OR MD 20167) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2014-06-24 |