| NPI | 1457542805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: RI MD10515) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: RI MD10515) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2022-12-22 |