| NPI | 1134136427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101229862) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 223226) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD12469) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-05-28 |