| NPI | 1104983659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 54892) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MA 54892) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: MA 54892) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 54892) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2017-10-23 |