| NPI | 1326032525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 7461) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 41531) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NH 7461) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 41531) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2015-04-06 |