| NPI | 1487035622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL me146095) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 161725) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL me146095) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 1.061944) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 1.061944) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CA 161725) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2024-05-01 |