| NPI | 1235490186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-39759) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2019035479) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 22707) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2022-08-23 |