| NPI | 1497716443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 44004) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WI 44004) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WI 44004) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 44004) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-02-07 |