| NPI | 1922053388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD431055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD431055) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD431055) | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: PA MD431055) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD431055) | |
| 209800000X Legal Medicine (Licence: MD D0060990) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-01-23 |