| NPI | 1841520210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 18136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 18136) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2010-01-07 |