| NPI | 1639272818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 152638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 152638) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 152638) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 21148) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2021-02-22 |