| NPI | 1619132560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2013009355) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0433894) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KS 0433894) | |
| 208600000X Surgery (Licence: AZ R70526) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2015-05-06 |