| NPI | 1336777168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX U9699) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A198351) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.172084) | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-04-30 |