| NPI | 1639158744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 17997) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WI 34475-020) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI 17997) | |
| 207Q00000X Family Medicine (Licence: HI 17997) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: HI 17997) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 100969) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: AK 100969) | |
| 207Q00000X Family Medicine (Licence: AK 100969) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AK 100969) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2017-02-15 |