| NPI | 1760460166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 46835) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: PA MD436683) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA MD436683) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD436683) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2021-11-12 |