| NPI | 1023267085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PR 17903) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: PR 17903) |
| 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: PR 17903) | |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2020-05-01 |