NPI | 1619356193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD16499) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03498) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP03498) | |
Enumeration Date | 2015-05-29 |
Last Update Date | 2021-08-12 |