| NPI | 1548279870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q3139) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-116587) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-05-07 |