| NPI | 1134210784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101035119) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: VA 0101035119) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: VA 0101035119) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: VA 0101035119) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: VA 0101035119) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-12-31 |