| NPI | 1396183125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine (Licence: MA 271243) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 271243) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2019-04-11 |