| NPI | 1972845709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: NV 17232) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 17232) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2020-12-15 |