| NPI | 1831161710 |
|---|---|
| Other Name | NONE NONE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101031222) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: VA 0101031222) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2013-07-02 |