| NPI | 1013229855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MD 37966) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116022945) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: SC MD 37966) | |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2016-03-23 |