| NPI | 1255770285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO193506) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI LP03060) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR DO193506) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2021-02-17 |