NPI | 1558417030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: OH 35.097436) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MD D65266) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2021-01-06 |