| NPI | 1952436958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 404510) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: MI 404510) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MI 404510) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-05-17 |