| NPI | 1215074687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T1024) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: TX T1024) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK MD25267) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-06-04 |