| NPI | 1437135183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: VA 0101259568) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX H0595) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VA 0101259568) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H0595) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-03-23 |