| NPI | 1740636653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 277180) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MA 277180) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 266943) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2022-03-11 |