| NPI | 1780622449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD11767) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: RI MD11767) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 200535) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2019-12-20 |