| NPI | 1790861714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MI 4301053537) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301053537) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2010-11-19 |