| NPI | 1962664011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: WA MD60704069) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD60704069) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: WA MD60704069) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2017-04-10 |