| NPI | 1235633397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T5914) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: TX T5914) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2023-11-09 |