| NPI | 1770746695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MI 53629) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MI 446) |
| 284300000X Special Hospital | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |