| NPI | 1093798852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 29241) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 29241) |
| 209800000X Legal Medicine (Licence: MA 29241) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2007-07-08 |