| NPI | 1720035058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: FL ME72560) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0070374) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME72560) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2024-07-08 |