| NPI | 1396275954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS16772) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125.071286) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-06-22 |