| NPI | 1790894681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-22634) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R5J12) |
| 207R00000X Internal Medicine (Licence: CA G73728) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO R5J12) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G73728) | |
| 207R00000X Internal Medicine (Licence: KS 04-22634) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-07-21 |