| NPI | 1306950639 |
|---|---|
| Former Name | KEITH HENRY NIBLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR MD08769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD08769) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2013-08-27 |