| NPI | 1497911267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036146080) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35139362) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301114259) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2022-03-30 |