| NPI | 1578641692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 37854) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 237214) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 237214) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: AL 37854) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-06-29 |