| NPI | 1962596734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN MD47728) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TN MD47728) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: VT 42-0007678) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-03-23 |