| NPI | 1942203690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 238390) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CT 49070) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD051072L) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ 25MA08883900) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: RI 09874) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2018-08-07 |