| NPI | 1063512804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 10804) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NV 10804) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NV 10804) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NV 10804) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-02-01 |