| NPI | 1578981239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 60978) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MN 60978) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2023008807) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2023-09-21 |