| NPI | 1306946454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology Psychosomatic Medicine (Licence: SC 30663) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC SC#30663) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC 30663) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: SC SC#30663) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: SC 30663) | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: SC SC#30663) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-09-15 |