| NPI | 1851978175 |
|---|---|
| Former Name | GREGORY JEBIAN BASTOURI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME176806) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: FL ME176806) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-08-11 |