| NPI | 1013979335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OK 16484) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OK 16484) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2020-02-18 |