| NPI | 1417440579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 79051) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 323348) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036155666) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2025-09-15 |