| NPI | 1528292091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301114495) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MI 4301114495) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD449659) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: DE C1-0011038) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2018-12-27 |