| NPI | 1154850113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI DO01427) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ME DO3588) |
| 2084P0805X (Licence: ME DO3588) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2025-05-07 |