| NPI | 1598887465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA 311337) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 033865) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: LA 311337) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 033865) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2019-06-04 |