| NPI | 1962606509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101241638) |
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: VA 0101241638) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-10-11 |