| NPI | 1528056561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 026707) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 026707) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CT 026707) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2012-06-27 |