| NPI | 1487798971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |