| NPI | 1235205790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR DO19447) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: OR DO19447) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-05-09 |