| NPI | 1205123056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2017-01647) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NC 2017-01647) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2023-12-18 |