| NPI | 1851706980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: RI MD17089) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: SC 37252) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2021-10-21 |