| NPI | 1114018298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 56237) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 29000) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-34333) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-09-28 |