| NPI | 1083676506 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD d0043630) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MD d0043630) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2025-01-12 |