| NPI | 1194791582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-18143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-18143) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2016-02-25 |