| 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 | 2025-10-04 |