| NPI | 1194171777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD16646) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 23486) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 322901) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP03582) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2024-08-26 |