| NPI | 1295775211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A63804) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 10276) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036115340) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-10-12 |