| NPI | 1407952658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036068001) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 44585020) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 30231) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |