NPI | 1629235015 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: DC MD041048) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P-22587) |
Enumeration Date | 2008-05-22 |
Last Update Date | 2013-02-01 |