NPI | 1558536425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME109815) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 242406) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD15006) | |
Enumeration Date | 2008-04-23 |
Last Update Date | 2020-07-06 |