| NPI | 1588827430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 246792) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP01519) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-05-15 |