| NPI | 1598795148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 14369) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 14369) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-01-05 |