| NPI | 1477563203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OR MD18191) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: OR MD18191) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: OR MD18191) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-09-20 |