| NPI | 1063675916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD150977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD150977) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125051347) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2021-09-15 |