| NPI | 1891754297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: NC 200100821) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: NC 200100821) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 200100821) | |
| 174400000X Specialist (Licence: NC 200100821) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200100821) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2023-03-07 |