| NPI | 1437644192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD17590) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP04383) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2021-07-06 |