NPI | 1376578336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: FL ME 58216) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: MA 203612) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2011-10-24 |