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 |