| NPI | 1902888464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: VA 0101-034020) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: VA 0101-034020) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2008-05-05 |