| NPI | 1093125759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.145663) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 2463) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T2322) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 308362) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME129546) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 160634) | |
| Enumeration Date | 2014-05-04 |
| Last Update Date | 2025-06-30 |