| NPI | 1972554327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: PA PS016648) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 002262) |
| 103T00000X Psychologist (Licence: PA PS016648) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-07-25 |