| NPI | 1437413937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R5122) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125-061935) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036139974) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2017-11-09 |