| NPI | 1144260621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX L1473) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 13341-321) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036177462) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2026-06-04 |