| NPI | 1265529515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G88223) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-078372) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 46480) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2023-11-27 |