| NPI | 1306340880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036156061) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL TRN26754) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME146513) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-10-10 |