| NPI | 1700958428 |
|---|---|
| Former Name | MATHEW WALTER SIPPLE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA os13457) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA os013457) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-02-11 |