| NPI | 1104804228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD0000045996) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: TN MD0000045996) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 15804) | |
| 2084H0002X (Licence: TN MD0000045996) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2017-09-14 |