| NPI | 1508351669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 66491) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125.073351) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-10-11 |