| NPI | 1568588218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: KY 16988) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: KY 16988) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 16988) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: KY 16988) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2013-04-17 |