| NPI | 1407877202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0005262) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0058183) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1 0005262) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2019-05-01 |