| NPI | 1487742243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 025691) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 17778) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD13289) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2024-02-20 |