| NPI | 1093819195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 0800289) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 08-00289) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 0800304) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2012-04-05 |