| NPI | 1114488467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD.41948) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 317497) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.165907) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-07-09 |