| NPI | 1114503166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-01120) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.166031) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NC 2024-01120) | |
| Enumeration Date | 2021-03-21 |
| Last Update Date | 2024-07-01 |