| NPI | 1578850277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036157021) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 42241) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ AB2268301-156) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-02-02 |