| NPI | 1306127311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NV 20660) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2023-02-06 |