| NPI | 1417302183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-46264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-46264) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2023-07-18 |