| NPI | 1497240113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 294160) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP04398) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD17527) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2022-10-03 |