| NPI | 1285687467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301051511) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301051511) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MI 4301051511) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-06-07 |