| NPI | 1992706857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: MT MED-PHYS-LIS-7430) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIS-7430) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2026-07-08 |