| NPI | 1982799599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: RI MD12514) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH rt1125) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: NH rt1125) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: RI MD12514) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-06-20 |