| NPI | 1295962066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2015-00894) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: WV 25736) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 25736) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2020-06-10 |