| NPI | 1750305546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2006014089) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: MO 2006014089) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-06-21 |