| NPI | 1447782321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX S9707) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-13255) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR DO207642) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 18821) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036155077) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-11-04 |