| NPI | 1336316959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: LA PGY.2.TUL-PSY) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 1336316959) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA PGY.2.TUL-PSY) | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2023-04-21 |