NPI | 1972605152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P7671) |
Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: PA MD059827-L) |
Enumeration Date | 2006-09-01 |
Last Update Date | 2022-01-25 |