| NPI | 1346602968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A173222) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125069541) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-03-06 |