| NPI | 1225295249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A106315) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0116016220) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.121203) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2017-02-08 |