| NPI | 1922538644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VT 042.0017013) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 323968) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD17074) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI LP04018) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-09-07 |