| NPI | 1043530728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2014004825) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036134624) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2015-07-22 |