| NPI | 1639180193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 51614) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036108411) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO R2F26) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-04-20 |