| NPI | 1316918204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC 21758) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: SC 21758) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2015-07-28 |