| NPI | 1477718310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX M5311) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35C.001902) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036172099) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2026-05-20 |