| NPI | 1467031716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.171026) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301515842) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 338945-01) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2026-04-14 |