| NPI | 1679732846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD14136) |
| Additional Taxonomies | 2084P0805X (Licence: RI MD14136) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2021-04-20 |