| NPI | 1437137346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 53057) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NH 15846) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-11-05 |