| NPI | 1558358689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 75226) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 8176) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 75226) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NH 8176) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-03-04 |