| NPI | 1659727261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD17092) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP03589) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2021-10-28 |