| NPI | 1235498338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: SC 51887) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 51887) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 076306) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2019-09-26 |