| NPI | 1376578252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 38586) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2001-01044) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NC 200101044) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: SC 38586) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-03-03 |