NPI | 1356645717 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036134428) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT196687) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-133335) | |
Enumeration Date | 2010-12-28 |
Last Update Date | 2018-07-05 |