| NPI | 1013438845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: PA MD490597) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101269905) |
| Enumeration Date | 2017-07-01 |
| Last Update Date | 2025-06-26 |