| NPI | 1598831232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 6357) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD04099) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 33023) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G865790) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2011-01-25 |