| NPI | 1710908330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 70184) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036163183) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-47826) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 320224) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2026-06-20 |