| NPI | 1750558045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101040220) |
| Additional Taxonomies | 2084B0002X Psychiatry & Neurology, Bariatric Medicine (Licence: MD D34382) |
| 2084B0002X Psychiatry & Neurology, Bariatric Medicine (Licence: VA 0101040220) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D34382) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |