| NPI | 1780940403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD190671) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A142587) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA A142587) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2023-05-10 |