| NPI | 1477565901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI 5548) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 37671) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: RI 5548) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 37671) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2014-04-18 |