| NPI | 1013099951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C52842) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-107338) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N6836) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2014-02-14 |