| NPI | 1487805503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 003261) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NY 003261) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2009-10-26 |