| NPI | 1518924745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-26830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-26830) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2018-11-01 |