| NPI | 1649345026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036171397) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35086733) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61590777) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2024-11-14 |