NPI | 1528406196 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 269936) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP02933) |
Enumeration Date | 2013-06-05 |
Last Update Date | 2017-08-25 |