| NPI | 1174621254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2014-0748) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125050520) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-03-31 |