| NPI | 1477970473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX S7658) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA 20A15800) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036.142543) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2023-09-12 |