| NPI | 1699970657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 290240) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD158381) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: RI MD13371) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OR MD158381) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 290240) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 290240) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD13371) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2022-02-04 |