| NPI | 1982998977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 74176) |
| Additional Taxonomies | 207QS1201X Family Medicine Sleep Medicine (Licence: GA 74176) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2015-08-18 |