| 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 |