| NPI | 1538516489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 286669) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP03686) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP03686) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: RI LP03686) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2021-09-10 |