| NPI | 1518955269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 32959) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 32959) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 32959) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: NC 32959) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NC 32959) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2010-10-06 |