| NPI | 1407276280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.149903) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA ML 60465553) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2021-05-25 |