| NPI | 1144226630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: DE C-0011443) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MA 44908) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: MA 44908) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2023-05-25 |